Definition of specific educational objectives in relation to a task

- Refer to the example of a task (p. 1.31): “Using a syringe, take a blood sample (5 ml) from the cubital vein of an adult”.

- Break it down into components. The main component is a practical skill, but the other two (communication and intellectual skills) are also involved.

- This type of act occurs frequently in the daily routine of health workers. It resembles the administration of intramuscular injections, lumbar punctures, puncture of ascites, pleura or articulation, gastric intubation.

- The communication skill appropriate to all these acts will be the same. It can be defined by acceptable types of behaviour which, when described in an observation table, can be used as criteria (introducing yourself to the patient, making sure that he knows what you are going to do, etc.).

- For all these acts an intellectual skill (which requires a certain amount of theoretical knowledge) is needed (anatomy, sterilization procedures, secondary effects, etc.): this is usually the prerequisite level which in its turn can be defined in terms of specific enabling educational objectives (also called contributory objectives):

- sketch from memory the position of the cubital vein;

- list the measures to be taken to ensure sterility during the act.

(In both cases criteria should be established from a textbook.)

- In addition to the task, certain criteria are proposed in this example (absence of haematoma; amount of blood taken within 10% of the amount required; not more than two attempts). These criteria confirm that the person who set the task considered the practical skill to be its principal component.

To sum up, a specific educational objective can be defined as a task accompanied by criteria indicating an acceptable level of performance for its principal component.

Specific Objective = Task + Criteria

Specific educational objectives

1.56

What are the qualities of a specific educational objective?

It must be all of the following:

Relevant: Its definition should be free of any superfluous material but cover every point relating to the aims in view, i.e., the general objectives derived from the health needs of society.

Unequivocal: “Loaded” words (words open to a wide range of interpretations) should not be used, to avoid any possibility of misunderstanding. What do we mean when we say we want a student to “know” something? Do we want him to be able to recite, or to solve, or to construct? To say merely that we want him to “know” tells him too little or too much. The objective is unequivocal when you describe what the learner will have to do to demonstrate that he “knows”, or “understands”, or “can do”.

Feasible: It must be ensured that what the student is required to do can actually be done, within the time allowed and with the facilities to hand. Remember, too, the basic condition for feasibility: the minimum (practical, communication and intellectual skills) to qualify for the course. This is the prerequisite level.

Logical: The objective must be internally consistent.

Observable: It is obvious that unless there is some means of observing progress towards an objective, it will be impossible to tell whether the objective has been achieved.

Measurable: One often hears “most of what I teach is intangible and cannot be measured”. Even rough measurement is better than none at all, for if no measurement is made instructors tend to assume that a goal has been achieved just because they have taught the subject. If your teaching skills cannot be evaluated, you are in the awkward position of being unable to demonstrate that you are teaching anything at all. That is why the objective must include an indication of acceptable level of performance on the part of the student.

This does not mean that an objective that does not lend itself to measurement by present-day techniques is necessarily a “bad” objective. On the other hand, the existence of a criterion for measurement will make it easier to choose or construct a valid evaluation mechanism, however sketchy this mechanism may be at the start.

At the same level of specificity as the specific educational objectives are the contributing objectives. These must possess the same qualities as the specific objectives corresponding to a professional task. They are concerned with the knowledge which the teachers in a traditional programme, and both teachers and students in a programme using the problem-solving approach (see Chapter 3), consider useful for the performance of a professional task.

Prerequisite Level

What the learner has to be able to “do” before undertaking an educational programme.

If you feel the list on the previous page is incomplete, go ahead.... add the active verbs relating to the category of health personnel that interests you.

Relevance is the essential quality of educational objectives

Objectives that have every quality except relevance are potentially dangerous

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Elements of a specific educational objective

1.61

the act

}

the content

}the task

the condition

}

+ the criteria

To say what one means by an objective is to reduce neither the importance of the objective nor its profundity ... the act of writing it down means merely that what was once secret is now open for inspection and improvement.

R.F. Mager

Description of the elements of a specific educational objective

1.62

Act and Content

- The act is expressed by an active verb describing the intent of the task aimed at.

- The content specifies the subject in relation to which the act is to be performed. (Example: “Repair a binocular microscope” or “take a sample of venous blood”. The act is the verb in italic; the rest of the sentence is the content.)

It is perfectly acceptable for the description of the act (of a specific objective) to be stated in terms of a “performance indicator” and not in terms of the actual act required, as long as the latter is quite clear.

The performance indicator is the description of an act whose satisfactory performance implies that the student is able to accomplish the actual act required. (Example: “Underline in the diagram the names of all the veins that pass in front of the corresponding artery.”) Here it is obvious that if the act consists of “underlining” it is only a performance indicator which shows that the student is able to “distinguish veins passing in front from those in any other position”.

In all cases, the appropriate procedure with regard to the act (the actual act or a performance indicator) is as follows:

1. Identify the act (for example, by underlining it in the sentence).

2. Decide whether it is an actual act or a performance indicator.

2.1 If it is a performance indicator, decide whether it enables an inference to be made concerning the actual act.

(a) If so, decide whether it can be simplified and whether it corresponds to the student's level.

(b) If not, write another one.

2.2 If it is an actual act, decide whether it is explicit or implicit.

(a) If it is explicit, decide whether it can be simplified and whether it corresponds to the student's level.

(b) If it is implicit, include a “performance indicator”.

Condition. This is the description of the resources available for carrying out the act (data, equipment).

Criterion. The definition of the acceptable level of performance expected from the student. It must be selected in close relationship with the active verb describing the act. It may measure the expected outcome following performance of the act or the process adopted to achieve it. An outcome criterion is preferable, for it provides a better measure of relevance, but it can be selected only if the outcome is entirely within the student's control.

Let us take a specific educational objective and identify each of its elements:

“Identify on frontal X-ray films of the thorax the presence or absence of opacities of the pulmonary parenchyma, of more than 2 cm diameter in 80% of cases.”

Act:“Identify the presence” indicates the act to be performed.

Content:“Opacities of the pulmonary parenchyma.”

Condition:“Frontal X-ray films of the thorax” are provided to the student.

Criterion:The student must identify “in 80% of cases any opacity of over 2 cm diameter”.

Some people mistakenly conclude that there is no difference between contributing objectives and test items. That is true only in the case where the main intent of the objective is overt. R.F. Mager

EXERCISE

1.63

Identify the four elements of the following objective:

To be able to: repair a binocular microscope (brand X, Y or Z) having been informed of the defect and given a descriptive diagram, appropriate tools and spare parts, so that the microscope functions according to specifications.

You can check your choice by turning to p. 1.76, questions 15 - 20 and the answers on p. 1.80.

Answers to exercise on page 1.54

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

P

++

++

+

++

++

+

C

+

+

++

++

++

++

+

+

+

+

+

++

+

++

I

++

++

+

++

+

++

++

++

+

+

++

++

++

+

++

+

If your choices were different, it does not necessarily mean they are “wrong”. Possibly the active verbs used for some of the tasks are open to several interpretations.

EXERCISE

1.64

Please Note!

N.B. Before you start this exercise you should cover the area in the shaded box.

Decide which of the specific educational objectives given below (prepared by participants in workshops) conform to the standards described in the preceding pages. Is each one really a professional task? Does it include an act and content, conditions and a criterion? (Answer Yes or No). What is its principal component?

Specific educational objectives. The student must be able to:

Professional task

Act and content

Condition

Criterion

Principal component

C

P

I

1. Make the diagnosis of anaemia on the basis of a detailed - haematological picture described in the patient's records.

Yes

Yes

Yes

Yes

++

2. Determine the health conditions of a family in its environment by making three home visits.

Yes

Yes

Yes

No

+

++

3. During a prenatal consultation, recognize at least three major symptoms of pre-eclampsia.

Yes

Yes

Yes

Yes

+

++

4. Give oral care with the available equipment (according to technical sheet X) to a patient continued to bed and conscious.

Yes

Yes

Yes

Yes

+

++

5. Read one issue of a professional journal every fortnight, outside working hours. Criterion: write a summary (not more than 10 lines) of at least one of the articles.

Yes

Yes

Yes

Yes

++

6. During a prenatal consultation, carry out examinations for detecting and preventing complications of pregnancy (according to technical sheet Y).

Yes

Yes

Yes

Yes

+

++

+

7. Make a survey (prepare questionnaires, carry out the survey, interpret the results) of the habits and customs of a population for the identification of those which represent a danger to health.

Yes

Yes

No

No

+

++

8. Give from memory two similar and two dissimilar characteristics concerning the immunological value of and the epidemiological indications for (a) inactivated, and (b) attenuated polio vaccines.

No

Yes

Yes

Yes

++

9. Measure the length of a newborn baby, using an infant measuring board, with a maximum error of 1 cm.

Programme truly based on the community's health problems and learner-centred

Some definitions3

3 Sources: Oxford English Dictionary (o), Webster (w).

Role: Pattern of motives and goals, beliefs, values, attitudes and behaviour (played by a person in society) which one has to assume (o); functions performed by someone (w); “the role of a teacher”.

Function(s): A set of activities, expected of a person by virtue of his position. (The function of a chairman is to “preside over meetings”) (w).

Activity: A combination of specific tasks whose fulfilment leads directly to the achievement of a function.

Task(s): Any piece of work that has to be done (o); a specific piece of work expected to be finished within a certain time; a set of actions necessary to the fulfilment of a given activity.

Competence: Ability required to carry out a task; sufficiency of qualification (o): the quality of being functionally adequate or having sufficient skill for a particular function; competence is a potential which is realized at the moment of performance.

Performance: The carrying out of a task: the doing of any action or work; the execution of an action.

Action: The process of doing, working (o).

Skill: Practical knowledge in combination with ability (o); dexterity in the execution of learned physical or intellectual tasks (w).

Human values: something that goes without saying, but is all the better for being said.

1.67

If the planners of the training programme wish to help the students to internalize a professional behaviour based on human values, it is important for the teachers and students to establish by consensus what is understood by these terms.

The following terms are put forward for you to think about.

HUMAN VALUES

willingness

readiness to accept advice

flexibility

discretion

perseverance

integrity

resistance to stress

genuineness

sense of responsibility

sensitivity

openness to change

tolerance

HONESTY

EMPATHY

RESPECT

ACCEPTANCE OF ONE'S OWN LIMITATIONS

In all our acts, human values are easier to describe than to demonstrate. They are not easy to measure either (see page 4.35). Students who lack these qualities at the outset of their studies are unlikely to acquire them later, and unfortunately they will sometimes encounter people who set a bad example by displaying the opposite qualities.

EXERCISE

1.68

1. Draw up specific educational objectives1 corresponding to three professional tasks that are familiar to you, stating explicitly what you feel the student should be able to “do” In relation to the general and intermediate objectives.

1 If necessary, refer back to the section dealing with their essential qualities, pp. 1.48 - 1.62.

2. Identify the principal component of each objective (domain of practical, communication or intellectual skills).

3. Define the criterion indicating the acceptable level of performance for each objective.

The student must be able to perform the following tasks:

1st task

2nd task

3rd task

EXERCISE

1.69

4. For one of the tasks, describe the theoretical knowledge you think the student should have if he is to be capable of working towards the corresponding objective.

Set out the content of this prerequisite level in the form of contributing educational objectives. Check that they include all the necessary elements (act and content, conditions, criteria).

To show that he has the knowledge needed for task no ......, the student must be able to:

5. For one of the tasks describe features of behaviour showing that the student has the communication skis you would regard as adequate were he responsible for a member of your own family. Describe this behaviour in terms of specific objectives.

For task no......, the student should have the attitude shown by the fact that he is able to:

EXERCISE

1.70

Check your Results

Indicate whether each of the specific objectives you have defined above satisfies the following conditions; use the flow chart on the next page.

It is really a professional task (or derived from one)? Has the principal domain been identified? Does it include the four elements: act, content, condition and criterion? (The criterion must relate to the principal component: communication skill (C), practical skill (P) or intellectual skill (I)).

Objective

Professional Task

Act

Content

Condition

Criterion

Domain(s)1

No.

Yes/No

Yes/No

Yes/No

Yes/No

Yes/No

C

P

I

1

2

3

4

5

1 Indicate the principal component by ++, others by +.

1.71

This flowchart is adapted from The definition of training objectives. Turin, Italy, International Centre for Professional and Technical Proficiency, 1985 (M.F.2.2.2.2/CMV/ILO).

Experience has shown that the systematic approach described in this chapter may be used in designing educational programmes, in research planning and in practical health work, and this has some important implications:

The relevance of an educational programme for health personnel will increase if the programme is required to be based on the health needs of the community.

The methods used for the planning as well as the implementation of educational programmes influence the ways in which learners approach problem identification and analysis, plan their activities and acquire problem-solving skills.

The sharp difference that most often exists today between activities in the sphere of education/training and research and community health care will soon become artificial, and - it is to be hoped - will finally disappear.

When education becomes a more natural part of the research process, teachers will no doubt develop greater interest in improving their competence in educational principles and methods.

It will become natural to recognize that real educational competence is a very important part of academic qualification, which will no doubt help to raise the standard of education.

EXERCISE

1.73

Instructions: for each question select one answer. (Check your answers on p. 1.80)

Question 1.

Which of the following statements is in contradiction to the theories expounded in this chapter:

A. The change in behaviour resulting from a learning activity is called performance.

B. Final behaviour is the designation of the observable act which will be accepted as proof that the student has achieved a given educational objective.

C. The definition of the objective of a course is a description or summary of the programme.

D. The teaching intent explained by the educational objective indicates what should be the final behaviour of the student.

E. None of the above statements.

Question 2.

An educational objective corresponds to all the following elements except one. Indicate which:

A. It is sometimes also called a learning objective.

B. It defines explicitly what the teacher should do.

C. It should be the basis for the preparation of the students' timetable.

D. It can be general or specific.

E. It is defined in behavioural terms corresponding to the taste to be accomplished.

Question 3.

Mager stresses the need to define educational objectives in operational terms (description of the type of behaviour aimed at). Among the following qualities select the one which does not correspond to one of the advantages sought by this technique.

A. It enables the student to evaluate his progress throughout his period of learning.

B. It enables the instructor to choose relevant examination questions.

C. It enables the instructor to make a satisfactory choice of teaching methods.

D. It enables the student to acquire a thorough knowledge of the content, organization and timetable of a course.

E. It enables the student to show clearly, at the end of the course, whether or not he has acquired specific types of behaviour.

Question 4.

A specific educational objective has all the following qualities except one. Indicate which:

A. It clearly communicates an educational intent.

B. It makes objective evaluation possible.

C. It defines a measurable behaviour.

D. It establishes success criteria.

E. It facilitates analysis of functions and tasks.

Question 5.

Indicate which of the following statements does not correspond to the principles of rational and effective educational planning:

A. Institutional objectives should be defined before selecting a student evaluation system.

B. Institutional objectives should be derived from the objectives of the various departments of a school.

C. Regional health needs should be considered before drawing up an educational system for training members of the health team.

D. Educational objectives should be defined before selecting educational methods and learning activities.

E. National resources and budgetary constraints should be taken into account before defining general objectives.

Questions 6 to 11.

There have been numerous classifications of educational objectives. One of them considers three domains:

The student should be able to name four new ideas concerning tuberculosis control.

Question 7.

The student should be able to measure the length of a newborn infant with a maximum error of 1 cm.

Question 8.

The student should be able, when contraceptives are requested by an 18-year-old girl, to give information on four available methods without expressing any moral judgement.

Question 9.

The student should be able to avoid giving guilt feelings to a five-year-old enuretic child.

Question 10.

The student should be able to construct, using simple data already tabulated, a histogram including title, coordinates and additional details without any mistake in the curve.

Question 11.

The student should be able to make a health education poster for an anti-smoking campaign, given a model and the necessary materials (paper, felt, charcoal, coloured pencils, glue, scissors).

Question 12.

Indicate which of the following definitions corresponds to the prerequisite level:

A. What the student should be able to do at the end of the curriculum.

B. What the teacher should summarize before every course so as to place all the students on the same level.

C. The level reached by the student while pursuing an educational objective.

D. What the student should be able to do before undertaking an educational programme.

E. None of the above.

Question 13.

Which of the following statements best corresponds to the educational aim to be achieved:

A. The student is perfectly familiar with the anatomical structure of the thorax.

B. The student appreciates the approach centred on the basic needs of the patient.

C. The student describes in writing the various steps of a nursing care plan in relation to the needs of a patient

D. The student has a thorough knowledge of the differences between a normal and a premature infant.

E. The student has a thorough understanding of professional ethics.

Question 14.

Indicate which of the following statements includes the four elements of an educational objective:

A. The teacher will give five one-hour lectures to a group of 20 undergraduate students. The lectures will deal with the physiopathological mechanisms of the inflammatory process.

B. During a simulation exercise, the student will give a brief written definition of the problem (at least 25 words) and list at least three alternative solutions, indicating which he would adopt and giving the reasons for his choice.

C. The student will show his knowledge of the mechanism of the action of aspirin on the subcortical cells.

D. Using an optical microscope (magnification × 40), the student will diagnose granulation tissue in five minutes, indicating at least four diagnostic elements present on the slide.

E. The student will demonstrate to his teacher, at the patient's bedside, that he has a good grasp of clinical method and sound critical judgement, without any prejudice to his relationship to the patient.

Questions 15 - 20.

Instructions. The following statement comprises certain elements numbered 1 to 4. Using the code given below, select the element(s) that correspond to each of questions 15 - 20.

(1) Repair (2) a binocular microscope (brand X, Y or Z) (3) having been informed of the defect and given a descriptive diagram (of brand X, Y or Z), appropriate tools and spare parts, (4) so that the microscope functions according to specifications.

A 1

E 1, 2

B 2

F 1, 2, 3

C 3

G 1, 2, 3, 4

D 4

Questions

15. Which is the task?

16. Which is the act?

17. Which is the specific educational objective?

18. Which is the content?

19. Which is the condition?

20. Which is the criterion?

If you help each learner to develop his/her learning objectives, you may not have to do much more than to check that these objectives have been attained.

adapted from Mager

What if it were true?.....

1.77

Notice to the reader

1.78

With some effort you have probably been able to reach most of the objectives indicated on page 1.02; this is the first and most important step but there is still a long way to go. Even to assist the students to define the specific objectives of their future professional activities will be a long job. And after that you must make sure that they correspond to the professional profile, whether explicit or not... and it would be reassuring to know that this profile is really geared to the health problems of tomorrow's population. Never forget relevance! And that is not all! Recent studies seem to show that teachers do not know how to use the educational objectives they have defined. There is no point in defining thousands of specific objectives if they are not then used as a reference for preparing the educational activities which will lead to their achievement.

There are other awkward questions. Do the objectives you have defined really reflect what is important or merely what is relatively easy to set out in the form of objectives? Will they really help the students, and will the latter be better trained than if ... etc.

You will be faced with these arguments sooner or later, probably by those who make no attempt to define their own objectives or to learn how to use them. Whatever the limits and drawbacks of this approach it has the undeniable advantage of enabling studies to be made and research to be carried on. To find replies to the questions raised above and many others there is an urgent need for research whose scientific rigour will increase the credibility of the arguments, theories and hypotheses put forward by education specialists. For, however logical arguments may be, they must be backed up by some proof. Thus any attempt at dogmatism in this field or insistence on defining objectives at all costs should be avoided. These indispensable studies will call for considerable experimentation.

You can help in carrying out such experiments.

If all this has not discouraged you, go on to the next chapter. Good luck!

It would be dangerous to measure with ever-increasing precision and objectivity educational objectives that are easy to measure (intellectual skills) and to neglect the more difficult ones (communication skills): what must be measured are those that are important for the patient and the community.

And don't forget

principle no. 1

community-oriented education is education oriented towards the community as well as the individual, taking account of the health needs of each particular collectivity.

and principle no. 2

learner-centred education keeps students in an active situation, gradually helping them to become the architects of their own learning activities.